Pre-Surgical Care and Preparation

How many inches should the sterile back table be from the wall?

12 inches

A nurse is putting 5000u of heparin in 500ml of normal saline on the back table. Which of the following is the concentration the surgical technologist should put on the label?

1:10

Which of the following describes a fenestrated drape?

A drape with an opening for the operative site.

Which of the following retractors should the surgical technologist have available for an emergent open laparotomy?

Balfour

Which of the following products is an alcohol based prep?

Chloraprep

Place the following actions in the correct order for hand scrubbing. (Click and drag the options in the left column to their correct position in the right column.)

Clean under the nails with a pick., Scrub the surfaces of the hand., Scrub the third of the arm above the hand., Scrub the third of the arm above the elbow., Rinse with the fingers pointing up.

During the surgical time out, the nurse reads from the consent that a right uretoroscopy will be done. The anesthesiologist confirms and the surgical technologist also confirms and announces the right side is marked. However, the surgeon says a left uretoroscopy will be performed. Which of the following should be done regarding this situation?

Halt the procedure until the surgical site is verified.

Which of the following retractors should the surgical technologist prepare for a cleft-palate repair procedure?

Jennings

The surgical technologist notices that her gown is saturated with blood and requests a change of gown. Which of the following is the correct procedure?

Remove the gown by turning it inside out, then remove gloves.

Which of the following should the surgical technologist do to prepare for a suction D&C? (Select the two (2) correct answers.)

Retrieve stirrups., Test the suction machine.

Which of the following is the minimum number of times a surgical instrument count should be performed for an open appendectomy case?

Three

Which of the following techniques is recommended for entering the operating room after preforming the surgical hand scrub?

Turning your back and pushing the door open.

The surgical technologist is setting up for a posterior lumbar laminectomy. Which of the following special equipment is needed?

Wilson frame

Which of the following positioning equipment is needed when preparing to do a posterior spinal fusion of the T3-L2 range?

Wilson frame

Gowns are considered sterile only from

chest to sterile field level in front, and sleeves from elbow to cuffs.

When performing a laparoscopic cholecystectomy with a cholangiogram, the surgical technologist will need to have

contrast medium.

When gowning and gloving, which of the following is always considered unsterile?

cuffs

Which of the following information should the surgical technologist place on the drug label when receiving local anesthetics onto the surgical field from the circulator? (Select the three (3) correct answers.)

drug name, expiration date, drug strength

When opening sterile supplies onto the back table, which of the following are two things to look for? (Select the two (2) correct answers.)

expiration date, holes in the packaging

Which of the following items should the surgical technologist expect to pull for a carpal tunnel release? (Select the three (3) correct answers.)

extremity drape, Alm retractor, tenotomy scissors

Which of the following irrigation will the surgeon need during an AV graft anastomosis?

heparin saline

The surgical timeout should be performed immediately before the

initial skin incision takes place.

Which of the following can be omitted from counts of a laparoscopic case? (Select the three (3) correct answers.)

laparoscopic instruments, trocars, Veress needle

Which of the following positioning devices should the technologist obtain for a total knee arthroplasty? (Select the two (2) correct answers.)

leg positioner, arm boards

Which of the following should be included when labeling medication on the sterile field? (Select the three (3) correct answers.)

medication name, medication expiration date, medication strength

Which of the following portions of the sterile gown remain sterile after donning? (Select the two (2) correct answers.)

mid chest to waist of the gown, elbows to cuffs

Which of the following items must the surgical technologist visually verify with the circulating nurse before receiving medication? (Select the three (3) correct answers.)

name of medication, strength of medication, expiration date

Which of the following is most appropriate for securing drapes?

non-perforating towel clips

Using gel pads during a surgical procedure helps to prevent

pressure ulcers.

Sequential compression devices are placed on the patient preoperatively to prevent which of the following during surgery?

pulmonary embolism

Where should the surgical technologist stand when handing four towels to square off the incision site?

same side of the operating table as the surgeon

A 35-year-old, 160 pound female patient undergoing a C-section has a history of DVT. Which of the following equipment should the surgical technologist have in the room?

sequential compression device

Which of the following are commonly reported complications of using a pneumatic tourniquet? (Select the three (3) correct answers.)

skin bruising, nerve paralysis, deep vein thrombosis

Which of the following is the proper placement for the safety belt in the supine position?

two inches proximal to the knees

Which of the following describes the area on the surgical technologist that should be sterile?

waist to the axillary line, and from the hands to the elbows

When performing pediatric surgery, the temperature of the room must be adjusted before the patient enters approximately

30 minutes prior and between 78.8 and 80.6 degrees Fahrenheit.

The nurse initiates a surgical time out with the surgeon not present and states the wrong patient identifiers. Which of the following is the best action for the surgical technologist to take?

Ask the nurse to repeat the time out once the physician is in the room.

A conscious alert patient is transported on a stretcher to the O.R. for a minor procedure. Which of the following actions should the surgical team perform to safely transfer the patient to the O.R. table? (Select the three (3) correct answers.)

Ask the patient to slide slowly onto the operating table, taking the top sheet along., Align the head of the stretcher with the head of locked operating table, then lock the stretcher., Free up IV lines and other tubing first, then transfer patient.

Which of the following is the proper way for the surgical technologist to enter a surgical room with a manually opened door after completing the surgical hand scrub?

Back first with arms up.

In an appendectomy where the patient is morbidly obese, which of the following self-retaining retractors is most appropriate to have on the sterile field?

Balfour

The facility is out of Mastisol. Which of the following should the surgical technologist pull as an alternative?

Benzoin

Which of the following equipment should the surgical technologist have available for an ORIF case? (Select the three (3) correct answers.)

Bovie, pneumatic tourniquet, X-rayable operating bed

The surgeon is starting an exploratory laparotomy on an elderly female patient with a very large rotund abdomen. Which of the following supplies should the surgical technologist have available in the room?

Bowel instrumentation and a Bookwalter retractor.

The surgical technologist notices there is water in the bottom of a pan after lifting the instrument basket out. Which of the following actions should the surgical technologist take?

Change gloves and notify the circulating nurse and Sterile Processing.

The surgical technologist is opening for an inguinal hernia repair and notices one of the caskets containing instruments was partially opened. Which of the following actions should the technologist take?

Consider the casket contaminated and ask for a new casket.

During a preoperative count the number of sponges in a package is incorrect. Which of the following actions should the surgical technologist and circulating nurse take?

Discard the package and open a new one.

The surgical technologist is preparing for a total hip arthroplasty. Which of the following surgical equipment is needed for this case? (Select the three (3) correct answers.)

ESU, lateral positioning devices, power drill

The surgeon plans to use the pneumatic tourniquet on a total knee. Which of the following should the surgical technologist have available on the sterile field to exsanguinate the leg?

Esmarch

When removing the instrument tray from the casket the surgical technologist finds no indicator. Which of the following should the technologist do next?

Hand off and change gloves.

Place the options below in the correct order for performing a surgical hand scrub. (Click and drag the options in the left column to their correct position in the right column.)

Inspect hands and arms., Open the brush packet., Clean under each nail., Scrub all planes of the fingers., Rinse thoroughly.

The patient is in lithotomy position with Allen stirrups. Which of the following procedures is the patient most likely undergoing?

LAVH

The surgical technologist and the surgeon have just finished draping for a hypospadias repair on an 8-month-old male. The resident doctor arrives to assist, places his gown and gloves on the back table, and returns to the room after his hand scrub. Which of the following is surgical technologist's appropriate action?

Leave the surgical field to gown and glove the resident.

Which of the following is the best place to don gloves for minor procedures?

Mayo stand

When the circulating nurse is dispensing a drug on the field, which of the following is the first thing the surgical technologist should do?

Place a sterile cup near the edge of table.

When opening a sterile envelope wrapped package, which of the following is the first step?

Pull the top flap up and away from you.

Upon inspecting the integrity of a package of heat-sealed peel packed rubber tubing, the surgical technologist notices a small pin hole. Which of the following steps should the surgical technologist take?

Refrain from using the damaged item and open another that is free of holes.

A laparotomy drape has been placed on the patient and un-prepped skin around the operative site is exposed. Which of the following is the next step the surgical technologists should take?

Remove the drapes and re-prep.

The surgical technologist and the circulator are doing an initial count and are short one Raytec sponge. Which of the following should the technologist and circulator do?

Remove the sponges from the room and open a new pack.

The surgeon has requested the scalpel and the surgical time out has not been initiated. Which of the following is the surgical technologist's best response?

Request the time out.

Which of the following situations requires the surgical technologist to re-glove members of the surgical team?

The procedure is a colon resection and anastomosis is complete.

The surgical technologist is preparing for an emergent laparoscopic appendectomy on a patient diagnosed with Hepatitis C. Which of the following measures should the technologist take to minimize risk of exposure?

Use standard precautions when dealing with this patient.

The surgeon tells the surgical technologist to drape the patient. Place the steps for draping the patient in the correct order. (Click and drag the options in the left column to their correct position in the right column.)

Wait for the circulator to prep., Place sterile towels around the incisional area., Drape the periphery and incisional areas., Secure the tubing and electrocautery.

Which patient positioning item should be tested prior to the patient arriving in the OR?

bean bag

Which of the following equipment is essential for a VATS procedure? (Select the three (3) correct answers.)

bean bag, video tower, pillows

An orthopedic surgeon has posted an I&D of a forearm using the pulse lavage system. Which of the following PPE is necessary to assist in this surgery? (Select the three (3) correct answers.)

face shield, shoe covers, gown

If a patient is in prone position, which of the following areas need to be padded for pressure points? (Select the three (3) correct answers.)

feet, knees, chest

Which of the following are used to drape an abdominal procedure? (Select the three (3) correct answers.)

four towels, three quarter sheet, towel clips

The surgical technologist is preparing for a laparoscopic assisted vaginal hysterectomy. Which of the following equipment is needed for the procedure?

harmonic scalpel

Which of the following instrument loads should have a biological indicator during the sterilization process?

implantable instrumentation tray

Which of the following must the surgical technologist check before opening a sterile wrapped package? (Select the two (2) correct answers.)

integrity of the package, external chemical indicator

Place the topics below in the order they are dealt with during a surgical time out. (Click and drag the options in the left column to their correct position in the right column.)

patient identity, procedure, site, allergies, equipment available

Which of the following do the surgical team members need to agree on during the time out? (Select the three (3) correct answers.)

patient's ID band is correct, correct site is marked clearly, procedure to be performed

Which of the following are verified in the Time Out process? (Select the three (3) correct answers.)

patient's identity, correct site, procedure to be performed

The patient is scheduled for an ORIF of the distal radius. Which of the following specialized equipment should the surgical technologist have available to achieve exsanguination?

pneumatic tourniquet

Where should the safety belt be positioned over a patient in the prone position?

posterior thighs and calves

Which of the following are acceptable surfaces to gown and glove from? (Select the two (2) correct answers.)

prep table, undraped Mayo

The surgical technologist ensures foam padding is effectively applied to all bony prominences before the surgical procedure begins. The purpose of this action is to

prevent neurovascular damage.

A patient with C-spine precautions comes to surgery. Which of the following should be used to transfer this patient from a gurney to the operating room table?

roller board

The surgical technologist is preparing the room to perform a total hip arthroplasty. Which of the following specialized pieces of equipment will the technologist need? (Select the two (2) correct answers.)

sequential compression device, electrosurgical generator

In which of the following surgical procedures is the beach chair attachment most commonly used?

shoulder arthroscopy

A preference card indicates the surgeon prefers an extra-large gown and size 8.5 gloves and the assistant prefers a small gown and size 6 gloves. The assistant usually scrubs first and uses an alcohol based scrub. Place the surgical attire below in the order it should be stacked from top to bottom. (Click and drag the options in the left column to their correct position in the right column.)

small gown, size 6 gloves, towel for surgeon, extra-large gown, size 8.5 gloves

Place the options below in the order they should be handed to the surgeon when assisting with gowning and gloving. (Click and drag the options in the left column to their correct position in the right column.)

sterile towel, gown, gloves, square off towels, surgical drape

Which of the following are signs and symptoms of malignant hyperthermia? (Select the three (3) correct answers.)

tachycardia, muscle stiffness or rigidity, unstable or elevated blood pressure

Which of the following is a special consideration before the procedure for a burn patient?

temperature of room

When preparing the room for a total knee arthroplasty which of the following items is necessary to occlude blood flow during the surgical procedure?

tourniquet

The surgical technologist is told to inspect the minor procedure rooms to ensure all of the basic furniture is present. How many suction systems are required in each room?

two

The patient is scheduled for a laparoscopic assisted vaginal hysterectomy. When opening supplies for the case the surgical technologist should open

two prep trays: one for abdomen and one for vaginal prep and catheter placement.

The surgical team is in the midst of the Time Out Protocol with the OR charge nurse present to audit their briefing. After stating the procedure, site of procedure, antibiotics administered, patient history, patient name and everyone in the room agreeing to the briefing, the charge nurse declared it a failed briefing. Which of the following elements of a Time Out did the surgical team exclude?

verification that the proper implants are in the room

Which of the following PPE is a surgical technologist working in decontamination required to wear? (Select the three (3) correct answers.)

water proof apron, face shield, shoe covers